Level 2: Mid-level evidence

Caregiver support was evaluated in a randomized trial of 406 spouse-caregivers of community-dwelling patients with Alzheimer’s disease (AD) (Neurology. 2006;67:1592-1599).

Caregivers were randomized to enhanced counseling and support intervention vs. usual care until the caregiver became too ill to participate or two years after the patient died.

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Caregivers had to be living with the patient at baseline and have at least one other relative living in the area in order to be eligible. The intervention included two individual and four family counseling sessions within four months, encouragement of weekly support-group participation after four months, and continuous availability of ad hoc telephone counseling.

There were multiple baseline differences reported between the groups despite randomization. Comparing intervention vs. control groups, 58% vs. 42% joined support groups within 12 months (P =.0015) and 48.8% vs. 54.7% of patients were placed in a nursing home. The estimated median time to nursing-home placement was 1,766 vs. 1,181 days (P =.015).